Breaking down the walls of silence and stigma surrounding HIV/Aids in South Africa

 


Chatham House Address by
Prince Mangosuthu Buthelezi, MP
President of the Inkatha Freedom Party
Chairperson of the House of Traditional Leaders
(The province of KwaZulu-Natal)
Traditional Prime Minister of the Zulu Nation

Chatham House, London:  March 8, 2005 

Mr Chairperson:

It is wonderful to be on this podium at Chatham House after I was last here more than thirty years ago.

I understand that the Chatham House Rule, before it was amended in 2002, was designed to guarantee anonymity to those speaking within its walls in order that better international relations could be achieved.

The topic that I have been asked to speak on tonight, I believe, is of such importance, not only to the future of my nation and the African continent, but also to the entire world, that I do not mind if, on this occasion, the rule is not applied to me.

My topic, ‘Breaking down the walls of silence and stigma surrounding HIV/Aids in South Africa’ is undoubtedly the biggest public policy challenge facing my country in our time. It is also a matter, I understand, of direct concern and interest to the United Kingdom.

The former Foreign Secretary, Lord Palmerston said in 1848, ‘England has no eternal friends, England has no perpetual enemies. England has only eternal and perpetual interests’. Palmerston said this when imperial Britain’s power was at its zenith. Though many in the realist school of international relations might argue that Palmerston’s dictum is the Rosetta stone of foreign policy, I contend that the United Kingdom is a friend of South Africa.

I, of course, come here tonight as a friend (some have even described me an as Anglophile!) with a keen and sensitive appreciation of the deep bonds of history that tie our peoples together. Well, they misunderstood my background which is partly British, in the sense that South Africa was a colony of Great Britain. To introduce myself, I am the great grandson of King Cetshwayo and a maternal grandson of his son, King Dinuzulu. It was King Cetshwayo’s Regiments that fought with the army of Queen Victoria in 1879. The Commander-in-Chief of all the King’s Regiments was my paternal great grandfather, Mnyamana Buthelezi, who was the Prime Minister of the king at the time. King Cetshwayo was the nephew of King Shaka, the founder of the Zulu Nation.

As the linear traditional Prime Minister of the Zulu Nation, I am the great grandson of my maternal great grandfather, King Cetshwayo, the direct descendant of King Shaka who was the founder of the Zulu Nation.

It was King Cetshwayo’s regiments that inflicted the worst defeat ever on imperial Britain at the Battle of Isandlwana on the 22nd of January 1879, during the Anglo- Zulu war. King Cetshwayo’s regiments were led by my great grandfather, Mnyamana Buthelezi, the then Prime Minister to the King.

After the then British Prime Minister Benjamin Disraeli told a dazed House of Commons that the Zulus were a “remarkable people”, no less than eleven Victoria Crosses were awarded in recognition of the defence of Rorke’s Drift which followed shortly afterwards.

A few months later, the Zulu Regiments were finally defeated by the British Army at the Battle of Ulundi on the 4th of July 1879. The course of my nation’s history changed forever. The country was divided into thirteen kinglets and the monarchy was suppressed. Thirty one years later the Crown Colonies and the Afrikaner Republics were consolidated into modern day South Africa.

Quite apart from our shared history and cultural, economic and social ties, the United Kingdom has been a presence and a staunch friend to South Africa during the dark night of apartheid. I think of the Free Nelson Mandela rallies that were held in Trafalgar Square.

I also recall the commitment of leaders like Baroness Margaret Thatcher, who resolutely opposed the injustices of apartheid, but knew that following the path of the armed struggle, sanctions and disinvestment would destroy the lives of the poorest of the black majority. I shall always remain indebted to Lady Thatcher for giving me such solid support in my campaign against sanctions and disinvestment.

Today, the United Kingdom continues to support South Africa as we face another challenge as great as apartheid in the scale of human misery it leaves in its wake.

As part of the new UK strategy on HIV/AIDS for developing countries, announced by Prime Minister Tony Blair in July 2004, the plan committed the UK to spending at least £1 billion over three years on AIDS-related work. A £30 million multi-sectoral commitment agreed to in 2003 has resulted in a programme which works with a range of partners in national and provincial governments, as well as with civil society and the private sector in South Africa. As a South African, I would like to say thank you to Britain for your assistance in our hour of adversity.

And we do live in a time of adversity. One in ten South Africans is currently affected by HIV/Aids. This means that one in ten people we work with in the office, or sit next to in a taxi, or in a Sunday church service, is infected. Can you picture this? Imagine that one in ten people you sit with on the London tube or pass by on the street are infected. In South Africa, this is equivalent to nearly five million people.

Within that figure, six times more girls are HIV infected than boys. Last year, two and a half times more young women in South Africa were HIV infected, than their male counterparts. It is girls and adult women who are bearing the brunt of the pandemic. We also know that in a country, where one in two women is raped in her lifetime, rape is a significant factor in HIV transmission.

I could carry on but I am weary of statistics. They do not tell the real human story. And they hide much more than they reveal.

In addition to the 5-million number of the infected, many more South Africans are affected by the disease. For most, understandably, the scale of the pandemic is still almost impossible to humanly comprehend. Scientists tell us we will not reach the plateau of this pandemic and feel its full impact for another decade or so.

As a leader, I have observed how, almost unhindered, HIV/Aids is decimating our people, tearing apart our families, and uprooting our communities in my home province, KwaZulu-Natal, and elsewhere throughout the nation.

Tragically, at the very time our nation needed to pull together to repair its injured society, the pandemic struck. Indeed, it is threatening to reverse much of what has been achieved in our country since the first democratic elections of 1994.

On the ground, the pandemic has redrawn the social map of South Africa and redefined many interpersonal relationships. It has created brand new categories of orphans, child-headed households, and terminally ill patients, who cannot perform their daily tasks without cumbersome assistance.

We have funerals every weekend in KwaZulu-Natal, the nation's worst hit province. In a vicious cycle, poverty means that people are more likely to contract HIV/Aids. The virus, in turn, makes poverty worse, as young parents get sick and die, leaving their children vulnerable and unprotected. Children, and girls in particular, are at increased risk from Aids.

In the fight against HIV/Aids in South Africa, the dice were loaded against us. Since the emergence of the disease in early 1980s, the world and South Africa experienced a steep learning curve. The debate began with the first statistics. Aids case data from 1982, where the first two cases were seen, to 1991 showed the majority of those infected were gay men.

The prevalence data collected by the apartheid government were primarily black women attending antenatal classes. The message was that this was a disease of gay men and black women.

When the new government came into office in 1994, in which I served as Minister of Home Affairs, nation building and reconciliation were understandably the top priorities and eclipsed the impending disaster.

And as cases of HIV continue to rise across the globe, including in high-income countries, such as the United Kingdom, where anti-retroviral drugs and triple therapy are helping to prolong lives, it is the rural communities of the developing world that are being decimated day by day.

Often we made and still makes things worse ourselves. While the world struggled with how best to combat the disease, some of our leaders argued about its very existence.

Despite scientific conclusions to the contrary, some politicians, pseudo-scientists and journalists have been sowing discord and confusion amongst the masses. I was particularly appalled last year at the nonsense peddled by writer Rian Malan, when he argued in The Spectator that the impact of HIV and Aids on our economy and society has been grossly exaggerated.

All this has contributed to a slow response to the pandemic. Bureaucracy and a lack of commitment have taken their toll. Despite a Cabinet promise in April 2002, to give HIV preventative post-exposure drugs to rape survivors, this rarely occurs in practice. Similarly, few HIV-positive pregnant women are given Nevirapine in order to prevent mother-to-child transmission of HIV.

According to the Department of Health's own figures, only about 12,000 patients countrywide are currently receiving anti-retroviral treatment. The chaos in the department has been exposed by investigative journalism which estimates the figure to be 14,000. Nevertheless, both figures fall alarmingly short of the 53,000 initially set by the Department.

In KwaZulu-Natal, which has the country's highest prevalence rate of HIV, only 930 out of the originally targeted 20,000 people have received treatment at the province's 31 test sites. Things are even worse in Limpopo province. Only 20 out of almost 7000 targeted people have received treatment. The situation is bad.

An additional, particularly horrific side effect of the HIV/Aids epidemic has been a throwback of the 19th century Europe when it was thought that having sex with a virgin could cure gonorrhoea and syphilis. In its South African incarnation, the myth of the “Virgin Cure” has been promoted as a method of preventing or curing HIV/Aids, and has been linked with a different epidemic – child and infant rape.

Nearly sixty children a day are raped in South Africa. According to the BBC, a girl born in South Africa today is more likely to be raped than learn how to read.

Amid such crisis, access to treatment is crucial. If appropriately prescribed, properly taken, and supported by a healthy lifestyle, anti-retroviral drugs can massively prolong the health and well-being of people who are HIV-positive. It was for this reason that my political party, while in government in KwaZulu-Natal, rolled out anti-retroviral drugs to prevent mother-to-child transmission of the HIV.

We also, in a joint action with the pressure group Treatment Action Campaign, took the national government to the Constitutional Court to compel them to fulfill their constitutional obligation to provide life-saving anti-retroviral drugs. Not only do we have an idea of the human misery and the death toll spawned by HIV/Aids, we also know that the pandemic will have a huge impact upon our economic performance.

This is already happening. HIV/Aids is depleting our workforce by thousands. It frightens away foreign direct investment at a time when we are trying to compete in a competitive international environment.

I was alarmed to read a report prepared for the World Economic Forum in Davos, which revealed that companies fail to draw up plans to cope with HIV/Aids until it affects 20% of people in a country. The report shows that despite the fact that 14,000 people contract HIV/Aids every day, concern among businesses has dropped by 23% in the last 12 months. Most, 71% percent, have no policies in place to address the disease. Nor could over 65% of the business leaders surveyed say, or estimate, the prevalence of HIV among their staff.

I must therefore applaud companies like Anglo American. This giant mining company estimates an HIV prevalence of 24% among its 130,000-strong Southern African workforce. Over the last two years, the company has implemented extensive voluntary counselling and testing for HIV infection, coupled with anti-retroviral therapy for employees progressing to Aids. Over 90% of the 2,200 employees, who have accessed and remained on treatment, are well and have returned to normal work.

I exhort other companies who have a presence in South Africa to follow Anglo American's example. Not just because it is the right thing to do. It also makes economic sense.

I am concerned that, in South Africa, funds for HIV/Aids still constitute less that one percent of the total consolidated budget. I contend that if our nation was fighting a military campaign against invading forces, we would allocate more than one percent of our resources to fighting it. How much more should we invest in fighting a war that threatens our very existence?

As I said before, yes, it will be expensive. And yes, it would have been preferable if we could have allocated these scarce funds to other worthy social programmes. But it is cheaper to confront Aids than ignore its disastrous effects and pay the full price later.

I appeal to our leaders to supply the measure of leadership given by President Yoweri Musevenii of Uganda. This Great Lakes country has reduced the infection rate from 30% to five percent. I wish this success story could be repeated in my own country. In large part, this was due to the openness of the Ugandan leaders in speaking out against the stigma and silence surrounding HIV/Aids.

Yet we can see clearly the danger of allowing notions of 'them' and 'us' to flourish here. We must accept that is it only ‘us’, as HIV/Aids does not discriminate. We are all at risk. While many are infected, we all are affected. The full awareness of this is essential if we are to eradicate the disease in the future. Millions of people have died unnecessarily as a result of ignorance. More will be claimed by the disease in the coming years, but many more can and must be saved.

This evening, I have touched briefly on the public policy issues relating to the fight against HIV/AIDS in South Africa. I would also, if I may, like to touch upon the personal.

Here in Britain, you are used to talking openly about sexuality. Parents are encouraged to talk to their children about sex. Thorny issues such as premarital sex, abortion, and homosexuality have long been aired in soaps like Eastenders and Coronation Street, the tabloid newspapers and formed part of the education curriculum.

In my culture, parents traditionally did not talk to children about sex. That was the responsibility of their older peers. I do not mind admitting that I have come a long way in my personal journey. If the leaders of South Africa have sometimes seemed a little tardy in their response, it is usually out of prudence rather than malice.

While full sexual intercourse before marriage is taboo in our society, our people are nevertheless realistic enough to know what the associated risks are. In the past we accepted that the sexual instinct is very strong. We therefore practiced the non-penetrative sex, known as ukusoma in Zulu or ukumetya in Xhosa. African problems require Africans solutions. It is quite clear that if we do not look seriously at some of the tenets of our moral code, we will not be able to reduce the incidence of this pandemic or to eliminate it.

My anguish at the plight of my fellow South Africans has meant that I have had to open my heart and mind to subjects that, in all candour, have long been taboo to talk about in my society.

For my wife, Irene, and me, there was not the deceiving cloak of anonymity, as the disease has struck down two members of our family, two of our own, beloved children. There are no words to convey the pain one feels, when the natural rhythm of life is violated and parents outlive their offspring.

When I remember my children, Nelisa and Mandisi, I recall that they never succumbed to a 'victim' mentality, but fought the disease with the courage and the spirit of those who never give up hope. And they did not. I derive some comfort from the knowledge that they live forever in the Holy City where there are no more tears or pain.

In today’s South Africa, the commitment to equal human dignity is the touchstone of our Constitution and Bill of Rights. Apartheid cruelly blunted our people's inalienable right to live in dignity. I fear the HIV/Aids epidemic runs the same risk. People living with HIV/Aids are at risk of being swallowed up in the anonymity of numbers. That is why we have to treat all victims of the disease as our own family members.

That is why I also salute my former President Nelson Mandela, who spoke out about the cause of death of Makgatho, his son, who also succumbed, like our children, to the pandemic of Aids more recently. He and I have come a long way and I salute his characteristic generosity of the spirit. Once again he put the country before self. I must also mention how inspired we were by the former British Cabinet minister, Chris Smith, who in announcing his HIV-positive status since 1980, stated that he was inspired to do so by President Mandela’s example.

Whilst I have conceded that I have undertaken a long and painful journey, I believe there are some things that do not change. At the beginning, I mentioned the courage of the Zulu Regiments at the Battle of Isandlwana in 1879. Historians amongst you will recall that King Shaka perfected the famous encircling tactic. This tactic, suggesting the horns of the bull, was used by the Zulu warriors with devastating skill and precision at the Battle of Isandlwana. Like on that fateful day, our people are once again experiencing an eclipse of the sun.

Just like the brave Zulu Regiments did in that battle, we must encircle this disease in unity to tear down the walls of silence and stigma that make us to vulnerable to the deadly virus which causes it.

Those like Nelson Mandela, Archbishop Desmond Tutu and myself, who have likened the scourge of HIV/Aids to that of apartheid, will know that it took a cloak of unity to defeat racial discrimination and injustice. South Africa will have to wear the same cloak when we overcome our prejudice and silence and confront the disease as one.

I am confident of victory. We have done this before and we will manage again. For a great nation like South Africa, there is no hardship that we cannot bear and no trial we cannot overcome. To another great nation, these spectred islands, I simply ask that you stand by us as you always have.

On this note, I thank you, my gracious hosts.

 

 

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